How much "pain and suffering" money to expect from an insurance settlement?
Posted by MarkMay 5
My wife was hit by another car about a year ago. She broke two fingers, which sounds trivial, but they were broken quite badly. She had one surgery where pins were inserted to heal the bones, and another to extract scar tissue that was limiting her movement. She was in hand therapy for a year, but she still doesn’t have anything close to full movement in the hand with the broken fingers — sometimes she needs help cutting a piece of chicken at dinner and things like that.
I estimate that the insurance company paid out about k for the hand therapy and another k for the various surgeries and doctor’s visits.
I assume they’ll be offering a pain and suffering settlement in the near future. How much should we expect? How will we know if they’re lowballing us? If I’m pretty sure they are trying to screw us over, is it acceptable to tell them we’ll get a lawyer if their offer isn’t more reasonable?
Question to reece010: Is that 50k on top of the medical bills (if the medical bills are 40k)? Or does that include the bills?
In response to questions:
1) Is she left or right handed?
Right.
2) Which hand was injured?
The ring and pinky fingers on her left hand. (And movement on the middle finger is also limited.)
3) Does she work outside of the home?
She’s in college and will work outside the home in the future.
4) What is the prognosis for a complete recovery?
Not going to improve further. It may in fact worsen in time.
5) Does she have scarring?
There’s a thin scar running down her ring finger, which was broken the worst.
6) Age?
24.
7) Attractive? (relevant for scarring)
Her hands were fine before, now the fingers are *slightly* mangled, enlarged, and lightly scarred.
Trouble completing her daily activities?
Initially yes, now it’s only occasional tasks like cutting a piece of meat. She’s figured out how to drive and type well enough.
9) Whole or partial AMA disability rating?
I doubt there would be one.
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Well, the facts show that if you are reasonable with your pain and suffering request and you deal honestly, fairly and reasonably with the insurer….you will get what you ask for and you will get it at least a year sooner and with much less hassle if you do it WITHOUT an attorney.
Just be as pleasant as possible and present a number that is within reason.
Don’t go way overboard on your request.
With an attorney (who will be getting a cut of whatever you get), the request will be for a lot higher than the insurer will be willing to pay. When (and if) they payout eventually comes….you’ll have to fork over up to 40% of the amount to the attorney.
But if you come alone to the insurer, present a decent number and then deal reasonably and honestly…..you’ll get your money right away.
The minute you ask for a ridiculous amount or jack the company around in any way….it gives them an opportunity to put the pressure on to fight the award…..that delays means lost money to you and more hassle.
Think about it this way…..you and the rest of us are all paying premiums to insurers…….when insurers have to pay out more than they should…that’s OUR money that getting paid out…..its not coming from the insurers’ reserves….what they pay out is what they charge us in premiums.
So just remember to be firm….but fair and you’ll find it will be a much better outcome.
I am sorry to hear about your wifes accident. You need to understand that you are dealing with an insurance company so while they have to pay the medical bills in full, whatever settlement they offer you is going to be as low as they think they can get away with. You are guaranteed to get more if you have a lawyer but there is a state insurance commission in each state that does nothing but answer insurance questions and in some cases they deal directly with the insurance company to handle the problem for you. You will be able to find them in your phone book in the state section and they will talk to you for free and advise you on laws pertaining to your situation and acceptable amounts and such things like that.
I say you should expect about 50k back. If they give you like 25k back there lowballing you and if they do do such a thing tell them your going to get a lawyer. You should have one on deck anyways. To get a good lawyer you should contact a Prepaid Legal company or seller
It’s really a tough call because a lot of it depends on the laws in your state. Here in Michigan, they have caps for certain damages that you would seek in a civil suit (like pain and suffering). Having said that, I can basically chisel it in stone for you that the insurance company is going to try and low-ball you, so remember that once you sign a settlement check you have agreed not to file any future claims or lawsuits. Bear in mind, however, the insurance company can only pay up to the maximum of the other driver’s personal liability/injury coverage. If it appears that your wife’s loss of dexterity in her hand is going to be permanent, go after the insurance company for the full personal liability/injury amount, and you may want to consider a civil suit against the driver as well. Above and beyond pain and suffering, you can also claim lost wages if this problem is going to make your wife’s job more difficult or if it will render her unable to work altogether.
***Update**
I would reduce slightly due to non-primary hand and the fingers involved. Since she is younger she will recover maybe a little better than a 70 year old would. A young woman always gets more for scarring. Make sure they get photos of hand. Remind them that is her wedding finger hand, as a woman that makes a difference (man may not realize). With new information I would probably reduce settlement to 15-30k (pain and suffering only). Keep in mind I still have not read the medical records and I am not familiar with your venue (some areas of country give more or less, depends on the people there). If the scarring is really noticable that will be what will drives the value of the claim way up. So play that point – especially that wedding ring is on that hand. People notice rings. Scarring is very subjective and varies by thousands from adj to adj. What I would give 20k for my male boss would only give 5k for.
Need to know a couple of things before I can give you a really good answer such as:
Is she left or right handed? Which hand was injured? Does she work outside of the home? What is the prognosis for a complete recovery?
But for conversation sake I will answer with the below assumptions:
She is right handed, right fingers injured, her restriction of movement is likely to improve but not completely, she has scarring, and she had significant physical therapy. I will also assume she is 30-50 years old, attractive (relevant for scarring) and has had trouble completing her daily activities. There has been no whole or partial AMA disability rating (if you can get one of these your claim value will be higher – ask your doctor)
Not including medicals I think 25-40k is reasonable but keep in mind I have not read her medical bills so this is just a ball park figure derived from VERY limited information.
Some things to keep in mind:
1. When adjustors make an offer they have a preset range approved. They of course are going to offer the low end of their range. The will often negotiate with you but you have to be reasonable. Let me give you an example (making up amounts): Adj has a range of 20-25k to settle claim. They offer 20k. You counter with 100k. They have no room to negotiate because 25k is their top end and an offer to you of say 22,500 is just an insult. If you were to counter with 30k they would have more room to counter.
2. Getting a lawyer is not a threat to an adj. Sometimes we prefer it, as they are easier to work with. If you were to get an attorney you would have to pay 35% of your settlement – that often includes 35% of the medicals. With that said if you have a jerk for an adj and you do feel like you are being screwed then yes, get an attorney.
3. Make sure you are clear on what your settlement includes. Make sure ALL medical and wage loss are included. If you are able to reach an agreement with the adj you will have to sign a release of all claims. This means you are done. You are not going to get any more money.
4. Get your own medical records. It will speed up the process by months and it will allow you to read what they are reading. They should reimburse you that cost. If they already have the records than don’t worry about it.
5. When you counter have a reason. A couple of things to argue with would be (a) duties under duress (insurance term) – this means she completed her daily activities but with pain, (b) loss of mobility, things of that nature
6. Be reasonable and friendly. We hate working with as*holes and are likely to be less generous when you are rude.
7. The adj may have a policy limits issue. What that means is they only have so much within the policy to pay out. For example if they have a 50k limit that means that is all they can pay with medical and pain and suffering included. They will advise you with what to do if that is an issue.
Good Luck.